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• 0 <br /> MONITORING WELL INSTALLATION REPORT <br /> Date: 9'Za-/3 CONSTRUCTION <br /> Premise Address: ���� n' Total Depth 132AU z 57' 132a- = 701' <br /> Screen Length (from) 55 77 (to) 45 G <br /> Well No.: in VW- 132-A Filter Pack (from) S41 79 (to)43 65 <br /> kA Bentonite (from) 43 /GS (to) `40 oz <br /> Inspector: '�'�� Grout (from) y0 (to) O <br /> �jljG+�(o 7233"0Drilling rig type SAPM c <br /> Permit No. Auger O.D. LO` <br /> Completion - Stove pipe(christie box circle one) <br /> Drilling Company: C.41SCa'D'E- <br /> Driller: f\)O(Ln-' H.-h'C-4F2 casing <br /> TffLT <br /> height <br /> Consultant FR M <br /> Geologist 3�1/�n M9 y E - T <br /> /ABOVE-GROUND C}{RZ Y-BOX <br /> =V LET O N COMPLETION <br /> SPECIAL PERMIT INFO. Ground Surf —7i' — <br /> Distance to sewer line grout <br /> Domestic well on site - (y/n ) Ntsr U —0 g, <br /> If yes, location and distance - 65-6 Z tt <br /> �S 7 tt• — L 43 -uo <br /> - m <br /> _ o <br /> — C <br /> O <br /> SAMPLING Slot ad <br /> sac5on <br /> Holding Temperature = VSVW pack <br /> Method <br /> Screening Method <br /> Tracking Sheet - (y/ n) _ �S <br /> 5a—43 <br /> SPOILS <br /> Storage Method full 0JC,(- 03 "j MATERIALS/DEVELOPMENT <br /> Contamination Noted - (y/C>) <br /> Storage Location Casing type Sch 1/0 PVC <br /> Blank I b[ ft. Screen Zo ft. <br /> Slot size . 01011 <br /> GROUTING Bags cement is <br /> 3«&SBw-%ets bentonite <br /> Depth to water ^' 33 Bags sand/gravel ZG <br /> Mix Ratios g fAA&5 3v &,4 J Filter Pack type/size Z/1 2 <br /> Installation Method Tt Surge Block: - ( y/lq3 <br /> Quantity Installed Discussed with geologist: - rD n) <br /> Type of method <br /> EH 29 29 <br />